Healthcare Provider Details

I. General information

NPI: 1821341173
Provider Name (Legal Business Name): WILLIAM ANDREW BRYSON PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2012
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1107 MEMORIAL DR STE 101
DALTON GA
30720-8662
US

IV. Provider business mailing address

1107 MEMORIAL DR STE 101
DALTON GA
30720-8662
US

V. Phone/Fax

Practice location:
  • Phone: 706-913-1336
  • Fax: 706-229-7676
Mailing address:
  • Phone: 706-913-1336
  • Fax: 706-229-7676

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0000036947
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: